There’s new wisdom about a brain diagnosis that shouldn’t be ignored.
Research consistently shows that experiencing a stroke significantly increases the risk of developing cognitive decline and dementia. A new study suggests that having a transient ischemic attack (TIA), also known as a “mini-stroke,” may have similar long-lasting effects on the brain.
Researchers from the University of Alabama at Birmingham followed 356 people who experienced their first TIA and 965 who had a first stroke.
The stroke group had the largest cognitive decline promptly after the episode. The TIA patients had their symptoms resolve quickly without immediate cognitive change, but “there was apparently sufficient impact to be associated with long-term cognitive decline,” the study authors wrote Monday in JAMA Neurology.
Dr. Raphael Sacho, director of cerebrovascular and endovascular neurosurgery at Northwell Staten Island University Hospital, said this new study demonstrates that patients aren’t out of the woods even when they don’t show overt stroke signs.
“Whether this is related to ongoing neurological damage that can be avoided with careful attention to preventing further TIAs or strokes remains to be studied,” Sacho said, “but certainly improving overall cardiovascular health such as blood pressure control, lowering cholesterol and diabetes management are very important.”
Here’s everything you need to know about TIAs, which affect about 240,000 Americans each year.
What is TIA?
TIA is a temporary disruption of blood flow to the brain, spurring stroke-like symptoms that typically last two to 15 minutes.
“A stroke is when the neurological deficit lasts for more than a few hours and is more or less permanent,” Sacho explained. “A stroke is usually accompanied by evidence of stroke changes on imaging such as an MRI scan of the brain, but often with a TIA there are no or minimal signs of a stroke on brain imaging.”
TIA is usually caused by a blood clot triggered by a narrowing of blood vessels in the brain known as atherosclerosis. Heart disease, atrial fibrillation and smoking can contribute to the risk.
TIAs are most common in people over 55. One in three Americans will likely experience one, raising the likelihood they will have a stroke.
“A TIA is often a warning sign that a larger or more permanent stroke may develop in the near future,” Sacho said.
What are the symptoms of TIA?
- Weakness, numbness or paralysis in the face, arm or leg, often on one side of the body
- Vision loss, blurred vision, double vision or difficulty seeing in one or both eyes
- Trouble speaking, difficulty finding words or slurred speech
- Dizziness, loss of balance or coordination
- Confusion or trouble understanding others
- Severe headache without a known cause
- Difficulty walking, swallowing, reading or writing
- Tingling in half the body
What should you do if you experience TIA?
Call 911 if you suspect you’ve had a TIA or stroke. If possible, have someone stay with you to monitor your breathing and consciousness. Note any changes in your condition to a medical professional during your evaluation.
“In many cases the best course of action is to attend the emergency room after experiencing a TIA to make sure there are no immediate risks for a further stroke such as a blocked artery in the brain or neck, and to rule out other conditions that may mimic a TIA such as a seizure or other brain lesion/brain bleed,” Sacho said.
A doctor will typically perform brain imaging like a CT scan or MRI to assess the brain tissue while checking for potential heart conditions like an irregular heartbeat.
“Often a TIA is a reflection of general cardiovascular risk factors such as high cholesterol, hypertension, diabetes that need to be controlled,” Sacho noted. “Often times a blood thinner such as aspirin will be prescribed in the appropriate setting once a brain bleed has been excluded with imaging.”
